HealthNet & CVS/Caremark – Screwing the pooch for 2010!

Sorry for the lack of updates. Between vacation, work/life, and lack of good and funny rants things have been sorta slow here. I intend to fix that for 2010. One rant twice monthly if it kills me. Too many posts don’t get the awesome comments, and too little makes people lose interest in the site. Twice a month is a happy medium.

On with the rant!

As you all well have known, we are in 2010 and we are one week past the dreaded first of the year mayhem. If you are a pharmacist, and have not died from alcohol induced liver failure you obviously have first hand experience about HealthNet (Or their processor, CVS/Caremark) screwing up SO bad that I can’t even believe that they are still in business.

For those not “in the know”, lets set a few things straight so people don’t get confused.

You have Medicare + Medicaid

You have no deductible (of usually $250 – $300 depending on plan)

You have little to no premiums

No doughnut holes (ie: the coverage gap)

Pretty much if you are on the state tit because you cannot take care of yourself, you get all the benefits of a Medicare part D plan without the annoying doughnut hole, deductibles, and screaming high copay tiers. Nice isn’t it? The rest of us however have the initial deductible, blah blah blah.

Now, lets rewind to HealthNet’s Medicare part D plan oh, a week ago. At least in California, NONE of the “Dual Eligibles” (the people with Medicare AND a state welfare insurance) were flagged in HealthNet’s computer system as being on a state welfare program. Which means that almost all of the people who should of had NO deductible suddenly got one (with a $200 copay for their Advair)! Compound this with the usual first of the year plan changing clusterfuck and you have yourself a 2 hour hold time with HealthNets pharmacy help desk!

Oh, lets not forget that HealthNet also didnt flag generic Vicodin and Septra DS as being covered items. So for one insurance company, we have a shitpot full of welfare-recipients pissed off at us because “we” want to charge them more than $1.10 or $3.20 AND their vicodin is no longer covered. So whats a pharmacist to do?

Easy. Let the fucking patient get off of their asses and take care of it themselves. Why should we have to suffer the fallout because some computer idiot over at CVS/Caremark (which I wonder if CVS pharmacies had this problem) totally fucked up the data import from California MediCal. Yeah, I’m a heartless asshole but I’m tired of being the human fucking shield for these PBM’s who make more per prescription than I do. What happened with HealthNet was completely unacceptable and embarrassing. Of course HealthNet/CVS/Caremark will continue to collect their fat ass subsidization checks from California as they tinkle in our faces with their whopping $3 above cost reimbursement. Here me now HealthNet, unless I see some MAJOR lawsuits from you to CVS/Caremark over this bullshit, I will do everything in my power to switch my Dual Eligible patients to any plan that is not administered by you.

Oh, and just icing on the cake, I got the fax yesterday evening from HealthNet that everything was fixed. Thats 8 days of chaos due to a company that makes more in 1 week than I’ll see in 10 years.

Post your hateful HealthNet comments (or funny first of the year stories) and lets see if I get a response from them (and hopefully not a C&D letter).

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Oh TAP, it’s so good to hear from you, I’ve been waiting with baited breath! I absolutely hate this time of year. No one has their new card yet, but of course, expects to get their meds with the correct copays. And how am I supposed to know what your new ins. is? Can’t just pull it out of my ass for you. Do you even know who you signed up with this year? do you at least have a letter from them saying who they are?? How about a bin # or something…& your member #-forget that one, it’s impossible to even guess. OK, that’s right, you don’t know that I flunked Mind-Reading 101. I’ll just get on the phone & be on hold forevvvvvver & you can stand there & glare at me with those impatient looks, I really don’t care.

Got an automated response from a PBM (can’t remember which one, I’ve called so many this week) that said they were so busy with calls, maybe I should call back tomorrow. TOMORROW?? This patient needs this vicodin TODAY!!!! Oh, that’s OK, they’re so understanding, they’ll just pay cash-right…….

WE RAN OUT OF PINK HYDROCODONE APAP 10/500- THE ONES WE GOT FROM THE WHOLESALER,TO FILL IN,WERE WHITE–AND YOU WOULD HAVE THOUGHT THAT THE WORLD WAS COMMING TO AN END– THE WHITE ONE MAKE ME ITCH– THE WHITE ONE’S MAKE MY STOMACH HURT— ARE YOU SURE THEY ARE THE SAME??(10 TIMES) ,ETC—-NOT ONE PERSON SAID THE PINK ONES SELL FOR MORE MONEY ON THE STREET I CAN’T SELL THESE WHITE M— F—S WE CAN CHANGE THE HEART,BLOOD PRESSURE,DIABETES MEDS,BUT DON’T MESS THE THE COLOR FOR THE PAIN MEDS!!!

Ha! We in Oregon also felt your pain 01/01/10…. when Care Oregon decided to change PBM’s and not even leave us a cute little love note for a rejection… just that all your medicaide patients just lost their PCP coverage for ’10! With many phone calls later, it was finally determined that they’ve switched from CVS/Caremark formerly RXAmerica (aka RX-bot)to Express Scripts. A week later, after we all had the stupid Bin, etc posted on little post-its @ our terminals, did a light bulb come on for the fine folks @ CVS/Caremark to actually post in the rejection bill Bin #… PCN A4… um… DUH!!!! This is info that would have been nice 01/01! Ya think??!

I never was a hateful person till I got into pharmacy…. now people from the ignorant drones that answer the phone @ x pbm help desk to the ignorant general public who think I really need to be their mommy simply disgust me.

WHY IN 12 YRS IS THIS CVS PHARASIST MAKING ME WAIT “OVER” 30 DAYS FOR 90 XANAX 3X A DAY ON THE 15TH I’LL HAVE HAD 84..ALL HE DID WAS TOTAL ALL THE ‘EARLY” TIMES I PICKED UP BUT DIDN’T SAY ANYTHING WHEN I TOLD HIM I USUALLY COME IN 3 DAY “AFTER” THERE’RE READY} IT DOESN’T PAY TO BE HONEST|USED THAT AGAINST ME SINCE PHARASIST EVERYONE KNEW AND LOVED WHILE SHE KEPT A GREAT PHARACY THIS TIME THEY HAD 4 PHARMS IN 4 MONTHS!! THEY SHOTRTED ME 6 MONTHS AGO 9 PILLKS WHICH WAS 3 DAYS AT 3 A DAY..THIS TIME THE GUY WHOSE THERE NOW IS AGGRESSIVE AND WANTED ME TO WAIT TO THE 28TH ON SEPT???? I GOT THEY WERE READY AUG 18 SUNDAY BUT I PICKED UP ON FRIDAY SO I HAD 15 LEFT WHICH IS NOT UP TO HIM TO JUDGE OR EVALUATE I SOMETIOMES FALL ASLKEEP SO I DON’T TAKE THE 3RD PILL WHY IS HE TOTALING ALL THE DAYS THEY GAVE ME “GRACE’PERIODS SAYING I GOT THEM EARLY THE SUPERVISOR SAID YOU’RE NOT EGTTING THEM EARLY ANYMORE? I NEVER GET OR CALL OR BERG MY DR KNOWS ME WELL AND HAS CPOMPLIMENTED ME RE:THAT I’M 61 FDEMALE & DO NOT OVERTAKE MY PILLS THIS PHARM HAD THE GAUL TO SAY ‘YOU SHOULD STILL HAVE 50 PILLS?” EITHER YOU’RE TAKING TOO MANY” WHAT!! NO WAY THEY PUT ME TO SLEEP BECAUSE I’M UP EVERY MORNING AT 5AM! SO EITHER I FALL ASLEEP & HAVE SOME LEFT IS NOT MY FAULT NOR IS MY FAULKT WHEN I GET THEME ARLY WHEN THE GIRL SAYS “THEY’RE READY” WE LIVE 25 MIN’S AWAY SO I DON’T ALWAYSS GO THE VERY NEXT DAY LIKE THIS MONTH I WENT IN SATURDAY THE 18TH THEY SAID THEY’D BE READY 19TH THE NEXT DAY SUNDAY,,BUT I DIDN’T COME BACK UNTIL THURSDAY..BETWEEN 12 & 15 LIKE I SAID,,NOW I HAVE TO WAITY UNTIL THE 22ND??THAT LEAVES ME W/ 2 DAYS OF “NOTHING” AREN’T THEY AWARE THAT BENZO WITHDRAWAL IS DANGEROUS?/ HE OBVIOUSLY MADE AMISTAKE HKEPT REPEATINMG “IM NOT FILLING THEM EARLIER” I SAID “I’M NOT ASKING YOU TO DO THAT”I DIDN’T EVER ASK THAT I WANT TOI KNOW WHY YOU’RE GOING INTO THE 5TH WEEK HE THREATENED TO HANG UP -THEN SAID I COULD GO TO ANOTHER PHARM -SO-I CALLED MY DR- HE DIDN’T FILL THEM NOR WAS HE CONCERNED KNOWING I NEVER ABUSED MY PILLS ADMITTING I’VE NEVER CALLED TO ASK FOR THEM ‘EARLIER EITHER! UNTIL THEY HEARD THE ENTIRE STORY FROM “ME” & WHILE I TOLD HER I WAS TERRIFIED OF BEING SICK I HAVEN’T A STRONG ;LEVEL OF TOLERANCE BUT TOLERNACE DOESN’T HELP I ALMOST FAINTED ONCE WHEN THEY “SHORTED ME” AFTER I THREATENED TO CALL THE SUPERVISOR HE SAID I CAN GIVE YOU 3 BY LAW SO I SHOULD HAVE TOLD THIS WOMAN YESTERDAY I’LL NOT HAVE ANYMORE BY THURSDAY THAT IF I HAVE TO BUY THEM I WILL,,& I AM!! I’LL NEVER BE AT HIS MERCY AGAIN..HE CANNOT EVEN REMAIN AT ONE PHARMACY IS HE A TEMP?} CAUSE THERE’S SOMETHING REALLY WRONG WHEN APHARM DOESN’T WUATION THE COMPUTER IT’S BEEN KNOWN TO WRONG [DA} HOW CAN HE HAVE ACCEPTED 5 WEEKS ANYWAY?? 19 TO THE 28?? INSANE THEY SHOULD HAVE BEEN READY THE 16 LASTEST BUT HE’S ADDING UP ALL THE EARLY’S? AM I SUPPOSED TO TELL THE GIRL THERE ‘NO I DON’T NEED THEM NOW EVEN THOUGH THEY’RE READY I DON’T MIND DRIVING & WASTING AGHS FOR A 25 MIN’T RIDE?’LOOKS LIKE AFTER THEY HEARD MY” STORY THEY TOOK AWAY THE EXTRA 8 OR MORE DAYS IS HE INSANE?? NUMBERS DON’T LIE BUTR COMPUTERS DO! HUMAN ERROR REMEMEBER THAT OLD STAND BY,, THEY MADE THE ERROR THE PHARM MADE IT & I WISH I KNEW WHAT THEY TOLD HIM..ABOUT HIS DANGEROUS ERROR,,I DO NOT HAVE TO WAIT UNTIL THE 28TH NOR DO I HAVE 50 PILLS HIDING ANYWHERE!1IF I FALL ASLEEP IT’S NOT HIS BUSINESS TO PUNISH ME IF I HAVE LEFTOVERS “DAMN YOU WHEN YOU DO & DAMN YOU WHEN YOU DON’T?”‘ HE SAID “YOU’RE EITHER TAKING THEM TOO MUCH????” OR THERE’S SOMEWHERE IN YOUR HOUSE?” CONTRADICTIONS!! I’M TAKING TOO MANY BUT LAST MONTH I HAD LEFTOVERS? PLEASE WHO DO I CONTACT TO WHO WILL INVESTIAGATE THIS? I AM JENILPET

One of the pharmacists at a local retail that I’m friends with called me up around the 2nd of January and said “let’s play a drinking game today, one shot for every fuck up by HealthNet” and I said “I might as well drink the liquor store dry”.

Don’t worry about a C&D, it’s only against the law if what you said was false HAHA!

We at CVS Pharmacy absolutely had the same problem. People were pissed at us last week! I don’t know how many times we can tell people that the insurance company is different than us, however we are just as much at the mercy of Caremark as any other pharmacy. Seems to be fixed now because we’ve been refunding people for 2 days now.

You forgot to mention the almost daily crashing of the CVS computer system. If only I had a nickel for everytime I heard “when will it be up again?” Add that to the seven days in a row work schedule (no overlap on some of them), the hiring freeze (2 techs left and will not be replaced). But get the PCI calls done, don’t get in the red, and answer the phone by the 3rd ring (while you are on the other line with WLPT because their own employees did not get new cards.) Now the PIC is out sick with H1N1. Color me surprised.

I am glad that you pointed out the problems with HNet. Even CVS folks were not informed of the problems. I am sure that CVS pharmacists also love to see “reject code 33”. That means we have to call the CVS helpdesk and get the correct Condor code in order to process the prescription with the “origin code”.

That is all the whining for this post…..just feeling demoralized today. Any attempts to cheer me up will be welcome.

i agree pci is a waste of time who has time to call 10 pages worth of customers harassing for business when the phones ringing,50 pages of readyfill on the screen, and people yelling about how much their prescriptions cost i mean who sits around and thinks of this bullshit

I’m in the same leaky rowboat that you’re in!!
We had the new “updated” CVS computer system installed a few months ago. We fill over 1000 scripts a day, and our computers crash every single day at around 1 PM. Then they fired 3 techs, we have 3 out on medical leave, they won’t replace any of them… and to top it off they cut hours because of “holiday pay”. Then they have the nerve to ask why customers are complaining about the wait time and why our PCI hasn’t been completed.
I know it doesn’t make it any easier but it’s nice to know you’re not the only one getting raped. My condolances 🙂

I feel the pain….My PIC has been arguing for months now about our budget cuts, and finally TODAY either yelled enough or, god knows what else, but got us at least more RPh hours. Not on the RxConnect yet, but I floated to a CVS that had one, and dear God if it has the same problems once it gets to us I will CRY.

Re: TAP’s post….I really don’t understand how after decades of electronic billing why they can’t get it right at the beginning of the year yet. It’s not like anything is going to be new; they need to either get new data entry folks or give them a pay raise or a view out a window or SOMETHING to get them to care more about their job so they can get it RIGHT for a change!!!

Couldn’t help but shake my head at this one. Being a CVS retail tech was not fun the beginning of this year. The new system pans out, for those of you who don’t have it yet. I’m just glad that the ins got fixed. Keep ranting, Angry Pharmacist. I may emulate you on my blog some day.

We had the same problem too. You know what I did? I started boycotting CVS. I decided I will not spent a penny at CVS. If they dont give us the tech Hrs, you are not getting my business. I make purchases at Rite Aid. Their prices are lower for the items that I buy. The store is much cleaner too. They are desperate for business. If Rite aid go out of business, the two mafia gangs (CVS and Walgreens) will eat us alive. At my store, the PCI calls alone is 12 – 15 pages, plus the consolidation calls plus the pick up calls … Nothing is enough for those rascals.

Our new tech schedule: 6 days per pay period but less than 8 hrs per day to give the full time people their 40 hr work week. Our tech who works in the hot seat (drop off) also handles PA and insurance issues and runs to the pickup window to help the one person usually assigned there. Wait, this week she is also out with H1N1!

The only Caremark bullshit we’ve been dealing with is the fallout from patients who ended up in Caremark plans and got letters that lead them to believe that they need to go to CVS now. Granted, we did lose a couple of people that we weren’t sad to see…

Our major problem this week has been with the Blue Cross accounts that are now *processed* by Caremark, where nearly all the patients’ insurance info has stayed the same except for the group numbers (but no one figured that out until 3-4 days into the year). And a mega fuck-ton of people whose insurance says that we should be billing a primary insurance, and then supplying us with account information for an insurance that can only be billed as a secondary coverage, when the parient doesn’t even have double coverage to begin with.

I have worked in pharmacies for about 8 years now and every single January is exactly the same. People act like having a deductible is some huge surprise that they have never heard of. I also got the question “can’t you just look my new insurance up?” 4 times today. Um no..you don’t even know what company you have. Where would you like me to look? People are so ignorant, it drives me crazy!

As much as the rebills and new insurances and o about 15 inches of snow we have had have annoyed my this past week, the worst has been our interns. Its January idiots, if ins is expired fill for cash and wait til the bring card do NOT staple reject to bag and then force me to not only enter card but also count pills and have them checked. I don’t think this is rocket science, a rebill is quicker then the entire filling process. O but interns make easily 2-4 bucks more then me, they don’t have to have common sense to get it apparently. We fill 4500 a week, by the way, so the last thing I need is a stupid intern. Glad your back AP i would love to hear from you twice a month

I don’t know that we ran into any of these problems, but we had the usual whining about copays.
“I didn’t have a copay last month. Why is it $35.00 now?”
“It’s a New Year and deductibles start over on Jan 1.”
“This is stupid. I’m not paying that much.”
“You are welcome to call your insurance company and discuss the issue with them.”
Then most of them would pay anyway.

Most didn’t bring the new insurance cards with them. Just wait a minute sir and I’ll devine that from my crystal ball. For medicare patients we used the cards that we found in the database rather than the card the patient handed us. We had fewer problems doing it that way.

Then I got the why can’t you have it ready in 5 minutes. Well let’s see I have 80 to 100 people ahead of you and it takes time to fill perscriptions correctly. But hey I’ll move you to the head of the line since you are in such a rush. But it is still goin to take 20 minutes to fill your perscription.

I pissed off a little old lady this weekend, who was upset that her copay went from like a buck to 3 bucks. I told her she had to call her insurance company. “But isn’t there anyone there I can talk to about this?”
Me: “NOPE! We’re not your insurance company. We only charge you the amount they send back. You have to call them and ask them. We don’t know everything about your plan.”
Her: “BUT WHY?! WHY DO I HAVE TO CALL??! *rant rant rant rant rant*”

And then another guy had a deductible and had to pay full price for a brand. I took him over to a phone and let him call his insurance company. Took him a good half hour to get through to them. THAT’S why I can’t call on a weekend, because there is much less staff and just as much volume.

My employer changed insurance companies this year. First, they didn’t get us our cards until the 8th. Then it turns out that the prescription insurance information is not on our cards, the insurance company website or really anywhere else. Hopefully, unlike our last insurance they will cover my migraine meds at the pharmacy (previous insurance only covered them if given in the ER – oh, like that’s cost effective!)

I hate this time of year. I’ve had everything ranging from ‘we don’t have cards, my insurance company said to call them and they’d give you the info’ that’s some BS right there…Then there’s the ones who say “I don’t have a deductible or whatever you call it..i just have to pay out of pocket until they cover it..” hear that sound? It’s the sound of my hand slapping my forehead. I also love it when they swear up and down that they haven’t changed plans..but then they hand me the ‘new card’ that the insurance company sent and it’s a different Bin, a different ID #, and different carrier…how can you NOT know that something has changed if your card says something completely different now?

I don’t have a funny new year story…but i do have an exasperating end of the year story. In the state where i live and work, prescriptions are good for 1 year from the date written. This man brings in a prescription in 12/30/2008 that is written for 90 with like..6 refills. Now…I hate math, but even i know that if he gets it every 3 months, there’s no way in hell that he’s going to get those 6 refills on his Benicar before the year passes. So he picks up a 90 day supply on Dec. 9 2009 and then comes in 2 days later and demands that he get his ‘last’ refill before his script expires on 12/30/2009. I patiently explain that if he wants it, it will be a cash price. He then asks why i can’t just explain to the insurance company that he “has” to have his refill because it’s going to expire. I tell him that it doesn’t work like that but hey, i’ll call the insurance. I do..he stands there…the insurance lady laughs at me for a good 3 minutes before telling me absolutely no override. The man freaks out and says “well, can you just run it on the 31st?” i keep my composure and explain that no…it doesn’t work like that. He leaves in a huff and complains to the store manager that i have not helped him. The store manager, who doesn’t really understand what we do back in the pharmacy anyway and barely breathes a ‘hello’ to us pharmacy employees, then comes back and demands that I fill his prescpription and just ‘go ahead and run it through the insurance this once’ like i can magically make it work. I told her very serenely that if she wanted to commit insurance fraud, then I wasn’t going to be a part of it.

The best thing that came out of this entire situation is that we went ahead and faxed a refill request for his meds so he could get his refills first of the year. The MD faxed back several times on all his meds denying refills and demanding that the patient be seen. Best time i’ve ever had delivering THAT message

Retail front managers are without exception complete idiots! They are either high school or the even rarer junior college drop-outs that thrive on their perceived power over the other lowly minions stocking or chashiering, but when they encounter pharmacy employees their little dictator show doesn’t fly. Now I just let them blabber on all the while digging themselves a much deeper hole that will require them to put their tail between their legs and grumble back to the fat/lazy/stupid (pick one or all) customer. Ahhh, the life of retail pharmacy has it’s occasional karmic events that make you smile temporarily.

I prefer to think of it as “enabling” the customer.
Encourage them to have a dialogue with their insurance company.

“The company will tell you information that they will not tell me” due to confidentiality and identity protection that statement is almost true……but mainly it is to let the patient talk to their OWN insurance!

And I thought working for a dentist was aggravating. I can only imagine how it is on your end of things. It’s bad enough you have the arrogant physicians to deal with, and now the asshole crack-head patients that expect you to be psychic. Put a magic 8 ball on the counter. Dentists are the icing on top of all that is retarded. I’d be snorting Xanax, alcohol alone just wouldn’t cut it.

I not only had the joy of working the first weekend of the year, but I also worked New Year’s Day. The ultimate Medicare D insult came from a dual eligible woman who told me to my face I was \stealing from the poor\ because her copay for DAW 2 LASIX went up from $3.20 to $6.30. I offered to call the insurance, and of course spent 25 minutes on hold with Medco while she glared at me from the front counter and proceeded to tell every other customer how we were now evil and stealing from her. From then on I decided people who didn’t like their copays could call their insurance themselves!!

I wouldn’t waste a second on anything from Medco–They are pushing their mail order so hard with the carriers that eventually we will only fill the garbage rx’s. Medco is Retail Pharmacies biggest enemy and is rapidly becoming the paracyte who kills it’s host.

O I can assure you, TAP, that CVS is having the same problems. While I SUPPOSE it would be nice to say otherwise, just because CVS and Caremark are owned by the same entity, nothing has given us more trouble than Caremark.
Just as an extension to your rant, in Connecticut there is a new arrangement, where Medicaid patients, effective Jan 1, 2010, must pay the first $15 of there copays, either $1.10 or $3.30 copays at a time for EACH month. The response? Patients that suddenly realize, “you know.., perhaps I dont need ALL these medications!” The end of the over medication of patients? Probably not, but its a good start…
However there are rumblings of a similar time, back in 200..2 i wanna say?…where the same copays were relayed to patients, however if the patients says “O well I cant afford this…” the pharmacy was REQUIRED to give the medication without the $1.10 or so charged. This was to help those who HONESTLY couldn’t afford their copays. It was a noble idea… However word spread that, if you simply SAY you cant afford the copay…YOU WONT HAVE TO PAY! Now tell me who in their right mind would pony up the cash when they didnt need to? Yeah thats right NO ONE. That whole situation didnt make it thru the year if I remember correctly…

So. What that means for today…Patients remember those times…remember it WASNT that long ago…and come to pharmacies the state over. They see these copays the state “requires” and say within their inner circles, “just REFUSE TO PAY! They CANT charge us!”
Unfortunately, that is NOT the case anymore… The State learned correctly I’d say, and realized how many people are abusing the system. THIS TIME…patients just pay $1.10/$3.30 UP TO $15 for each month! Previously it was a year long $1.10 copay required. So the problem TODAY…CVS pharmacies for instance, WILL NOT give out the medication at no charge. Not gunna happen, as of now. However…GUESS WHO IS AT THE BOTTOM OF THE FUNNEL TO TELL THE WELFARE ABUSERS THIS!

….yeah u got it. Honestly for some, it is hard to say, “I cant give this out no charge! Talk with your case worker!”…to those who I know HONESTLY cant pay for medication they NEED.
However the problem comes when the abusers start showing up in force, angry that there once walk-in-walk-out without droppin a dime days are over. And here we are….to explain..over..n over..n over again, what the new arrangement is. State claims they sent a letter out to everyone, but you think they’ll remember that? Nah-uh.
So it’s my belief, TAP, that something is gunna give. Personally, I think this is a pretty fair arrangement thats been set-up. Allows for patients to show SOME kind of responsibility. Dont get me wrong! Many(few) are responsible(VERY FEW!) But this will be good for the many(MOST) who arent.
Somethings gunna give, and whether it’s the State going back to the old plan, or patients accepting that the Healthcare system is in sore straits and must adjust accordingly, I HONESTLY dont know…

This comment got a little outta hand. =P I’m very passionate about the subject.

We had that issue a couple of years ago in Wisconsin when they changed all the medicaid hmos into one central processing system and a lot of the people who had been used to $0 copays got hit with $1 or $3 copays. They gave us a copy of the letter that was sent out to all cardholders and we made copies. When someone claimed they never got, or didn’t see the letter we had copies of the letter to pass out to them. Check to see if you can find one or get a copy, they couldn’t say much after we handed it to them.

We have been so overwhelmed and over-loaded with first of the year insurance crap, that we just started telling people basically it is THEIR RESPONSIBILITY to supply us with the correct information, otherwise it is THEIR RESPONSIBILITY to call their benefits administrator to get the correct information if they are going to let their insurance be tardy with supplying them with new cards. We won’t get on the phone and call their insurance for any problems that can be taken care of by them. Period. We won’t deal with them wanting to give new insurance info over the phone, either. We won’t be bullied into being responsible for things not concerning pharmacy; their insurance is their deal. If they present us with info and it goes through, fine, if not, they have to take care of it. We *had* to start doing things this way, our sanity was at stake.

I’m having some issues with CVS/Caremark from the patient end of things. They tried to bill me a $539 penalty because I had the nerve to want the brand name medication for migraines. Their generic crap doesn’t work for me. Thank god the credit card info was old and I hadn’t updated it. It took them 6 weeks to correct the “FastStart” mess. My doc sent them THEIR forms. How could they misunderstand them? I hate them. And they call this a health benefit.

It goes without saying that 99% of us pharmacists would love our job if there were no insurance companies and PBM’s to deal with.

At what point do we finally just say fuck it, no more insurance

One thing is for sure; pharmaceutical companies would have to start charging fairer prices if they wanted to stay in business………..but of course big daddy gov’t would intervene and tell us that we have to accept their prescription insurance or risk jail time

And yes, CVS/caremark blows big time; but then again, being the best prescription processor simply means being the tallest midget.

Ahhh January. I don’t miss retail in January. I work at a pharmacy that fills meds for LTC, AL and hospice patients. I am excited about the twice monthly postings! Love your rants and tweets! Keep it up.

I really just don’t understand how retail stores are still surviving with this stuff going on. I swear if I worked/ran a retail store I’d make all patient’s file their own insurance claims and run it cash only. The insurance guys have made it too hard on the pharmacies.

All of these problems at retail pharmacies are coming to a head very quickly. Doing a large volume of scripts PLUS insurance bull crap PLUS a rediculous amount of H1N1 shots every day, is driving everyone nuts! This is simply an overall bastardization of retail pharmacy! (Don’t even get me started on the damn drive-thru) Trying to get all of this done with minimal tech staffing, hardly enough RPh overlap to get their lunch breaks, and to top it all off, the usual rude and inconsiderate “patients” staring us down as if we’re purposely taking our sweet-ass time. “Yes, Ma’am, It really DOES take 30 minutes to fill your PER-scription correctly and safely.”… “No, ma’am, we do more than just slap a label on a box…” But, in spite of all this, I really do enjoy my job in the pharmacy and my fellow co-workers. Thankfully we all share the same sarcastic sense of humor. It really helps us through our day. I hope most or all of you are as lucky as I to have a great team to work with! God Bless, and stay sane! 🙂

Here in Connecticut our dual eligibles have always had their Medicare D copays picked up by Medicaid. Starting January 1st the state switched their billing procedures and people are now required to pay $15 in copays per month. Of course a letter was sent out by the state, but imagine this, no one received it (you know, because they’ve moved 7 times in the last year). Talk about a shitshow. I now have to stand there and fight with people who have a better cell phone than me and an Escalade over $1.10. Why do we continue to do this to ourselves? Thank God for beer

A 70+ year old woman comes to the drive thru to pick up her 5 medicines…..last year she paid nothing on all her copays. This year her copays are $4, totaling $20. She bitched and moaned for a few mintues, blaming obama mainly. After she gets done whining about paying a whopping $20 for her 5 medicines, she rides off in her 2010 Lexus Rx. I was at a loss for words. You apparently have no problem making a $40,000 purchase yet bitch and moan about something that costs 2,000x less. Simply amazing

I covered a couple of vacation days for a pharamcist the other week. He took his family on a trip the first week of January. I’m beginning to think it isn’t that bad of an idea to take the first week of January off work as a pharmacist just to avoid the inevitable insurance nightmares that happen at the first of the year. Oh well, things should get better as the weeks go by.

what about the people who change med d plans and by law are required to provide at least 30 days of uninterrupted coverage in the event a med is not on their formulary. so much for that. i had a lady who switched to a new plan, was on brand tenormin and the new med d plan was not covering the brand…understandable. but what about the 30 days? … the plan help desk told me to try a different ndc….moron, brand tenormin is one and only 1 ndc. i wish these pms were clser so that i could drive there and punch them in the face

In all fairness to the people you get on the other end of the phone (at the pbm companies)we can only give you what we have been given… the training sucks, the management does not communicate important changes to us regarding the plans that we handle and if they do it is usually in the form of a handout that we are supposed to read in between calls (that are back to back in que)… and on top of that, we aren’t able to really learn the plans that we handle because they keep piling more clients on us to handle… it is really ridiculous, the whole darn process and system

This year the insurance problems have not been that bad for us. I think that our training of patients throughout the year is paying off. Our techs have memorized the correct approach to dealing with any insurance problem and repeat the words each and every time. We have only called on two patient’s insurance.

In case you think we are a slow pharmacy, we fill 350 per day while being open only 10.5 hours. We usually do this with one pharmacist, 3 techs and 2 clerks. We are an independent pharmacy that closes at 7PM M-F, 1PM on Sat and closed on Sunday.

I think that all pharmacists who are unhappy with CVS, Walgreens, etc. should consider switching jobs and work for an independent. Competitive pay, better hours, off holidays. Once you work at an independent you will never work at a chain again.

One pharmacy issue I will comment on is drug seekers. We have a huge problem with drug seekers in our area. We have a former nurse calling in prescriptions for several patients. The doctor and patient changes each time. Being a former nurse, she is very good. They have gotten so bold as set up a fax line to approve refills on their fraudulent prescriptions!! No shit!! Gotta love those druggies!!

The insurance companies are not the real problem in chain pharmacy. It is the chain that accepts those plans. Why doesn’t the chains FORCE the insurance companies to provide the patients with new insurance cards in a timely manner? Why don’t the chains FORCE the insurance companies to put ALL the information on that card? I believe I can answer that question. We pharmacists don’t complain enough to the chains! I know you are going to say it does no good. No, it does no good if only one of us complains. But, what would happen if we bombarded these chains with complaints every day? You get what you tolerate, and we are tolerating too much crap. Lets join together, act in unison, and FORCE changes.

I keep hearing that pharmacists will not organize. Ok. I am one pharmacist. All that is needed is one more pharmacist and we have an organization. It happens one pharmacist at a time until there are lots of pharmacists. Better still, go join The Pharmacy Alliance where there is already an established organization. Make it grow…by guess what? By YOU joining! And, after you join, offer your ideas on what you think needs to be done, and then join others in doing it.

Pharmacists are not the only ones Health Net is messing with. I am one of the disabled Americans who have a Health Net plan. I changed over to them after moving from Missouri to California at the end of October. I had everything set up ahead of time so there would be no lapse in my coverage as I have a blood condition that requires monthly monitoring. When I arrived in California and tried to make a doctors appointment I was told that he did not accept my insurance. So I called Health Net and changed my primary care physician to one in the plan. When I received my ID card, however, it had a different doctor listed. I called Health Net only to find out the the second doctor they signed me up with also did not actually take the plan so they randomly choose a doctor for me. However, the doctor they choose did not fit my requirements, so I signed up for a third doctor…..and again received an ID card with a different doctor because the one I had chosen (with the help of a Health Net representative) did not accept the plan. Finally yesterday I was so irritated that I called Health Net and told them to find me a doctor that actually took their plan. Well, guess what….I got a call today telling me that after I had hung up with them they again came to the realization that the doctor did not take the stinkin plan. Unfortunately for me, the open enrollment period is over. I plan to call Social Security tomorrow and tell them that not only do I need a new plan, but they should require Health Net to refund them for the last three months since I haven’t actually been able to go to a doctor. This is ridiculous!

Somehow I don’t think this is correct… Health Net doesn’t randomly select doctors for anyone, unless you are a new enrollee… after that ONLY the member can change their dr. Maybe instead of wasting your time not knowing how your plan works, maybe you should use your time reading over your EVIDENCE OF COVERAGE (EOC) it explains everything about your policy with the insurance co. .. you are the one who should be researching on a dr, request a provider directory, check the internet… there are alot of resources that people can use, but are sometimes too lazy….
I know this post was in the beginning of the year, but I would still like to comment on this.

I must admit this year has not been as bad as last years jan. I did have one interesting thing happen this week, a patient on a expnsive cancer drug was told by his insurance that he had to pay 2300$ every month because of where he is in his coverage. No thats just his copay on his 8000$ med, well he is a medicare patient and therefore cannot get coupons or FUELPERKS by law. He reported us to our complaint line because he couldnt get fuelperks on his 2300$ bucks. I spent easily 20 minutes trying to explain that it is a law we cannot override it, we cannot commit fraud and fake him a label to get fuelperks. he didn’t care it is all our fault and the customer service people rate us weekly so his big long complaint which included words like ” cheat ” and ” rude ” and ” trickery ” lowered our rating enough to get us in shit with our GM. Why do customers think all pharmacies are out to “get them” I really do not get it.
O and I am off to my Caremark interveiw today, lol.

I have my 2 turn of the year stories. One sad, one the guy got it. First guy came in on Jan 3rd. It turns out he’d paid $0 for a whole year for generic Coreg on his plan. This year it came back $10 copay. The patient said eh you figure it out, ill pay and then you can refund in a week. So the claims adjudicated just fine. So I call the help desk. I spend 10 minutes with the first person with a headset on who informs me that the patient does not have their insurance because they cannot possibly find them in their system. I told them they are a complete idiot because the claims adjudicated so he is in your goddamn system somewhere, I know it. So after repeating the patient’s name, DOB, and ID# 3 times with the same response I just hang up and call back again. I get apparently the lady sitting next to her. Except this time she finds the guy in the system on the first try. Turns out guy was suppose to pay $10 all last year for Coreg, but fell into some sort of loophole so was getting it for free. Told the patient. He said to me, “Did they tell you if I would have to pay for all those copays, cause I shouldn’t have too”.

The second lady was at the store for some reason her Part D plan had paid for Xanax XR 2mg and Xanax XR 3mg all of last year for a $0 copay. I said ma’am I have bad news, these drugs are not covered under medicare part D. I don’t know how you got them for nothing all last year. “Oh there must be an error in your system, I get them for $0. If they aren’t covered, why did they cover them last year?”

To which I have no reply, cause yeah Aetna why did she get them for $0 all last year if they aren’t covered under part D law?? All I can say to the patient who fell to the floor and starting crying when I told her how much they would cost is to call her insurance company to see if they can mail them to her cheaper and in the specific GreenStone brand she wants.

I am so damn glad to be out of this line of work. I just come back every now and then to see nothing’s changed. The worst part about pharmacy is carrying everyone else’s water. Whether it’s the insurance’s, the doc’s, or the patient’s, you’re always taking the blame for something that isn’t your fault. Personally, in my days in the pharmacy, I always believed we just did too damn much for free. In other words, when the turd that wants you to call his/her insurance to find out their coverage information says “My insurance company said to call them.” We should be able to answer, “Sure no problem that’s a $3.00 insurance clarification fee.” “What!!!???”, says the surprised patient. “Well who’s going to pay for my time to do that?” It’s called fee for service, moron. I mean hell Blockbuster charges a $1.50 restocking fee if you’re late with a video, why the hell should pharmacy be providing freebies. That will cut down the number of patient responsibility issues quick. With regard to the insurance screw ups by PBM and Processors etc., class action law suit. When they screw up like this all the pharmacies should get together and sue for damages, due to reduced customer service and lost profits due to their errors.

How would you like to be comin’ out of school now with a 50-60 thousand dollar debt and have to put up with this shit for 40 years. It’s great to be an old man! Medical marijuana could prevent the impending pharmacist shortage due to liver failure. If you didn’t injure yourself from laugh syncope attacks.

It always amazes me how many people do NOT check their mail! About 50% of customers in week one of Jan. had a new insurance plan. Did they even have a fucking clue that they had a new card in the mail??!!! OF COURSE NOT! Apparently I didn’t get the memo that I am supposed to know which insurance every moron that comes into my pharmacy should now have!! So I made a rule for myself before the 1st of the year, that if a claim was rejected because the customer’s insurance was expired that I would not be making any calls to find out their new insurance. NOT MY FUCKING JOB! It’s crazy how many people seemed to have no problem finding their correct insurance info once I refused to be their personal assistant. I love it when you ask them for their new card and they say that they never received one. Then they give you that blank stare and are completely silent for 60 seconds or so (creepy and awkward!). This is usually when I want to grab a bottle of Promethazine with Codiene Syrup and bash them over the head with that heavy ass glass bottle! They finally ask me what they are supposed to do and I tell them to go look for their card or get ahold of their employer. They always swear up and down that they never got a card in the mail. Magically an hour later they show up with a card!!!!!! OMG!!!! Miracles do exist! I love that I have to force people who are twice my age, I’m 25, to be a reasponsible adult and take care of their own shit! Of course there is the one tech at my work that doesn’t stick to the “no calling for insurance rule” and I end up having people bitching me out because the nice asian guy said to come on in and we would figure it out.(He just happens to be off work when they come in). Thank God I get to cut into dead animals at school to relieve my anger. I can’t wait for it to one day be my last day working in my pharmacy! I hope every fucking welfare white trash drug seeking fuck that I have ever had an issue with comes in that day!!!!!! I might even stay late that day just to rip into a few extra people. Especially this one fat know it all nurse that I can’t stand!!!!!!!

What I do not understand is how is CVS/Caremark allowed to exist? This is a violation of antitrust law. How can this company continue to be allowed to force patients to their brick and mortar and mail-order? This is unfair competition. It is not good for the consumer. It is not good for patient care. I have patients come to my stores all the time with complaints of poor patient care and serve. Our government broke up movie makers and movie theaters. That was entertainment. This is peoples lives. This relationship allowed by our government is concentrating wealth and power to fewer and fewer corporations. In pharmacy, brick and mortar pharmacies, Mail-order pharmacies, healthcare entities like Kaiser and PBMs should not be allowed to have any business relationship. They should be required to be separate business entities. If this is not fixed in short order Walgreens and Rite-Aid will each own one or the other of Medco and Express Scripts and then WalMart will buy them all. The days of pharmacy as a profession are numbered if this is allowed to continue.

CVS/Caremark and etc are able to skirt antitrust laws because they have the politicians “bought off”. It comes down to “votes” and the politicians get votes by advertising and they get advertising by having a lot of money to spend. They get that money in the form of corporate contributions to their campaign. The corporations don’t directly buy their vote, but their contributions “sway” the politicians legislation. The politicians don’t want to lose corporate support.

The more I have thought about it, the more I have come to the conclusion that pharmacists are going to have to pressure the corporations to change. How do you do it? By sending letters and emails to corporate headquarters regarding unsafe work conditions. We are going to have to build our case. All it will take is one or two lawsuits by pharmacists to force change. Document unsafe working conditions. Always fill rx’s carefully with the safety of the patient coming first. Then, take care of number one. Too many distractions…write corporate headquarters. Don’t complain to the DM. Send a registered letter to corporate. Feel pressured to fill too many prescriptions…write corporate. What are they going to do fire you? If they do, then you have grounds for a lawsuit. Sue the bastards! Then, take a trip on your award to the Bahamas…drink margarittas…live the life of leisure. 🙂

Oh Yeah! I should have realized it was you with the stupid idea to write letters to corporate complaining about unsafe working conditions, distractions ect. Right. All this crap comes from corporate idiot! The shit runs down hill. Let me spell it out for you. Highest boss leans on 2nd highest boss, all the way down to your DM, who leans on you. But then again, your taking your time, taking care of number one. Seriously, what world do you reside in? Are they going to fire you? YES. THEY ARE. For a peon, you have a rather large ego. You’ll be drinking margaritas in the Bahamas before you know it pal.

And if only this was a once in a life time event….I bet same or similar shit goes down again next year when new year comes again. Just like it did last year, the year before that, and the year before that. Seriously, is it a industry rule for insurance companies to screw up come new year? I’m so glad I’m out of it.

Yeppp CVS’s new computer system is a mess (getting better though) but I can’t believe all you whiners complaining about techs not being replaced. Each store replaces it’s own technicians. Hire them, dammit. Don’t come on here and lie about how CVS is stopping you from hiring staff. There’s no hiring freeze here. Jeez, people are so whiny.

Just to say that at Walgreens, there isn’t a hiring freeze, persay. It’s that our hours have been cut drastically. We have less tech hours ( a lot less) to do MORE work. District will not let us hire unless there are budget hours to work with. Which don’t exist at my store, or any other store in the whole state, it seems. Maybe it’s the same situation with CVS? I wouldn’t be surprised. I just hope CVS doesn’t try to implement centralized Third Party Resolutions, RX Entry, Data Verification, Central Fill, etc. for your guys’ sakes. Walgreens has all that shit here. And it’s terrible. They hire newbie ‘techs’ to answer phones and type rx’s that don’t know the first thing about what they’re doing. So now, on top of your normal duties, you have to fix all of their mistakes. Frankly, I’d rather do something myself cuz at least it’d be done right. I may sound a little know-it-all-ish, but damnit, I know my job and I hate relying on other dumb-fucks to do my job.
Sorry for ranting. Had to get it out. I’m losing my mind, I just thank God the first of the year is now a month behind us.

I believe that one reason pharmacists have not been allowed to write prescriptions is because the legislatures and state boards considered pharmacists would use their prescription writing authority for profit. But, here is CVS/Caremark. Don’t you think this is a marriage for profit?

I haven’t come across this particular problem and I work as a tech at CVS, then again I’m not there every day and after all this post-xmas/new year stuff alot of problems are all just blurring together at this point. I started working at the peak of flu season and I couldn’t have picked a worse time to get thrown in with an almost criminally minimal amount of training (several web courses and one instructor led class). After hearing all this about the new computer system, I’m gonna have quite a bit more to look forward to when I go to work (taste the sarcasm!) whenever we get it that is.

By the way I love all the ideas that people have posted for getting the customers to handle their own problems, I’m gonna have to suggest a few of these to my pharmacist!

Jim…jeez yourself, man. Must be that the DM is lying to us. I will be sure to tell him you said it is ok for us to start hiring again. So glad you cleared that up.
Thought it was ok to “whine” here without fear of getting scolded. My mistake.

Ugh, I hate this time of year. Those people paying $1.10 and bitching because it should be free is the last thing I need. Patients coming in wanting their new prescriptions at their insurance price without their cards. When I tell them I can’t process through their third party I get a new asshole from each on of them. I’ve already been bitched at to the pharmacist 5 times because people had to wait for the asshole that wouldn’t leave the drive window because “My husband has been with this company for 40 years and we have never had to deal with this” bullshit. I feel better now… for now.

One of the pharmacists I work with said he is going to open up a NEW pharmacy, called the CASH OR DIE pharmacy. Cash only, no insurance no medicaid. Nothing that has to be opened and counted. All narcs – double in price.

I have a friend with the same idea. A cash only pharmacy might work in the right situation. It sure would save the staff a lot of hassles and I would assume margins would be better. In the end the question is would you get enough business to survive? My guess is that compounding is the only real escape from insurance problems in retail pharmacy these days. But if someone can come up with a cash only pharmacy business model that is feasible I’m all ears!

Yehhhh! Yes, I’d say we are one annoyed bunch. Just a couple of comments…If you didn’t realize it, we are in the “dark-time” of our retail pharmacy careers. I’ve been in retail for 24 long years. Aside from the consistant and long standing refusal of the customers to take ANY responsibility for their prescriptions, the “dark-time” is a time when just as you thought things could not get any worse, they do. Cutting tech hours is the way of retail, but never this severe. Then they begin to cut pharmacist hours. Stores that previously had 30-40 hours of overlap (actually allowing you to take a dinner break, which will happen over your dead body when you are alone, not that you the corporation you work for REALLY wants you to take one, even though your state board of pharmacy had to pass a mandate (law?) so that you would be allowed to take one…wait I digress; I will get back to the break thing) now have 5-10 hours of overlap. That’s right don’t get carried away with that 1 HOUR A DAY of overlap!! Ah, yes but they promise to give you more tech hours, and ok well maybe that will work because admittedly sometimes you are just teching. And then you call us in for a regional meeting & tell us how much MORE money the corporation made this year than last year and the next day YOU CUT OUR TECH HOURS!! THENNNN, we are supposed to make 500,000 harrassing sales calls a day, complete the task list, answer the phone (NOW) in case it’s the DPS/DM calling to check up on how long it took you to answer the phone, get EVERY FUCKING prescription out in 15 mins or less, yell at your drivethru specialist to get their ass over to the window, filling in excess of 450 rx’s a day and checking ZERO red prescriptions, because after all doesn’t: “check more prescriptions, faster” go hand in hand with good patient care? To hell with patient care! Let’s sit in our fine leather chair, in our office with a view and dream up more jobs to keep those slackers in the pharmacy busy so they aren’t wasting our money getting something to drink or going to the restroom or anything like that! In the past it might have been a lot about making money & some about caring for people, but NOW! it’s all about making more money and not a thing about patient care. And when you are directed to do something or correct some of your numbers; ie. wait/promise time the conversation ends with the legalese needed to fire you if necessary “And if you are unable to do this, we will assume that you are not willing to do your job” NOT WILLING! Go ahead, replace us all with new grads and see how well things run then! Don’t talk to me about customer service and employee engagement when it’s 11:30 Friday morning & I’ve got 16 pages in the que and 2 technicians. There’s nobody in production fully half the entire day but me, “The Lone Ranger” Printing, pulling, counting, verifying all by myself, hoping no one says “consultation”, answering as many phone calls as I can because my TWO (2) techs are actually talking/helping at least 2 of the 5-15 people standing out there staring at you, wondering what the fuck you are doing and why their shit isn’t ready yet. Because all of those impatient waiting customers are blind AND deaf, they have NO idea how busy you are! Because they built pharmacy with 7 points of entry I have to hope my multiple personalities show up every day. Whew! I feel much better.
So, Where is the pharmacist shortage? Which state?, so I can move there. And, what are they going to do?, fire you? Yes, they are. So I put up with it, make myself insane, drive my family nuts. I’m a pharmacy whore.

yes my dear tap, i have the entire plan you speak of medicare-medicade we really do get the best benefits in this hmo. low low low co-pays i still complain tho hehe just to get the rphs reaction then we leave laughing with goodies in hand as tech rph screams at us. no donut hole i love the guy that thought of that one because poor people have more needs than rich white people.

You do realize that poor trash such as yourself wouldn’t be getting all those “goodies” if it wasn’t for the “evil” rich white people, right? I know that taxes are really hard to figure out, but if every so-called rich person were to leave this country and take their money with them, you would be royally fucked. It’s our tax money that pays for your luxuries. You aren’t poor, you probably own a car, live in a section 8 house, get food stamps and buy cigs, drugs and alcohol. There isn’t poor in this country. Poor is where you are starving, have no medical help, walk everywhere and live in a hole in the ground. Poor is a 3rd world country where there are millions dying from simple diseases you will never experience. YOU ARE NOT POOR, YOU ARE SIMPLY LAZY AND NEED BIG GOVERNMENT TO SPOON FEED YOU OFF OF THE WORKING MAN’S DOLLAR!!!!! Just keep in mind that if they can give hand-outs, they can take them away just as quickly. When they decide that it’s too much of a hassle to keep you alive, they will decide to pull the plug and let you die of whatever you were taking the free meds for. Sounds like a bit of Karma in the making. Enjoy it while you have it, Dumbass.

I have been standing in line and watched as horrible people insulted and bashed pharmacists. One in particular was a mother and her approx 13 year old daughter. They claimed something about the insurance, with the daughter calling the pharmacist an effing idiot! I was horrified. I’ve also personally known people who were/are TRULY poor who many of them still haven’t been able to get on disability, ahcccs, or anything else. I don’t know if she is inany kind of section 8 housing. I don’t think so. She has been diagnosed as paranoid schizophrenic, has severe scoliosis and has been told she needs to get epidural injections every six months or so. She has been turned down by Social Security three times. She had no idea that an attorney could help her and she had no money to hire one anyway. She finally was taken to an attorney by a friend who the minute she walked into his office and he took one look at her and said, “I’m taking your case”. She is one of several people I have known who were somewhat disabled nearly from birth. Some were marginally disabled but not bad enough to receive any benefits. Most all of them tried hard to go to school or find a job but unfortunately most of them were on the slightly more disabled side of the marginal line. These are the people who truly need help. And they can’t afford expensive attornies, and don’t even understand how to get the many freebies you mention. The idea of someone driving off in their Lexus or something complaining about a $3 co-pay is obscene when this particular girl has never even had enough money to even learn to drive.

I had an interaction with a lady who was \giving me her last $8\ for a snack and freakin Enbrel (yes, Enbrel for $3). She mentioned she had just filled up with gas so she should be ok. I commented on the gas shortages that we had been having in the area, to which she replied with how hard it was to find premium gas for her Range Rover. Seriously? These people always have things in their carts more expensive than what they’re paying for prescriptions, and then the copays are still too high. Priorities…

Mojome, I feel your pain. I bet you still answered the phone by the 3rd ring! It is a sad day indeed when you realize you are not alone. I certainly would like to hear from some folks who feel that their jobs are just great. Is there anyone out there like that?

What I hear in lot of these comments is complaints about customers, no lunches, no breaks, and “having” to fill x number of rx’s. First, no one can force you to fill x number of rx’s or force you to fill them in any certain amount of time. YOU are the professional. Simply look at each “customer” as a patient and take of them one at a time. If the lines grow long, then so what? You can only do so much and do it safely. If there is more than one pharmacist on duty, take a break a couple of times a day…take a lunch. If you are the only pharmacist, then get your sandwich and find a corner, tell the techs to not disturb you for 15 minutes, and eat your sandwich. I can’t get over so many pharmacists acting like a bunch of kids. Whining about being “forced” to do certain things. Let me inform you…you are adults and you need to start acting like adults. No one can force you to do anything against your will unless they have a gun at your head. Don’t rush at your job! Don’t worry about the lines of people. You cannot control the number of people that come to get rx’s. The only thing you can really control is yourself. And, you can control the pace at which you work. YOU are responsible for taking care of the PATIENTS. And, you better realize that they are PATIENTS and not customers. All it will take is one bad mistake to ruin a PATIENTS life and YOUR OWN LIFE and cause your company to lose a years worth of profits. It is in everyone’s best interest for you to be a professional and perform your job in a professional manner. The number of people in line, people in a hurry, DM’s pushin you… does not mean a thing. What is important is how well you perform your responsibilities as a pharmacist and a professional.

Are you even a Pharmacist? Most pharmacist don’t even have 15 min to find a corner and tell the tech not to disturb them. Here in Wisconsin the pharmacist has to coucinl EVERY PATIENT….It’s the LAW. And I’m pretty sure they have to verify every script in EVERY state. A tech can not council patients or verify scripts. They do their best to take the time they need to with each patient and sometimes it’s a little difficult when you have 1 pharmacit and 1 tech and you have 10 people in line….people in drive-thru…..and three phone lines ringing at the same time. So I don’t know what pharmacy you work at or go to but every pharmacist I have ever worked with has treated every customer they come acrosee as a PATIENT and do their best with what they have!

I remember working for one of the chains about ten years ago and not being allow to take a lunch break on Saturdays (9 to 7PM shift). Forget about the lunch break, how was I supposed to take a piss when I had no tech or cashier?

Finally fed up the nonsense, I closed the place down for an HOUR and went across the street and ate like a human for once. My DM called later that day. I told him to fire me or give me a lunch. I got the lunch.

I kind of missed those times telling patients about that fax newsletter notifying us that patients on medi-medi were going to be fucked until they fixed it. OMG how many patients were annoyed at those copays!

(mini)peon, Lordy, Lordy, you make me laugh! Allow me to say I am an excellent pharmacist who enjoys talking to customers, giving advice and listening to their problems. I am well regarded as a professional in my community as well as respected with my employer including immediate bosses (DPS & DM). Every day I strive to do my best, helping people. HOWEVER, the CUSTOMERS that are ONLY in a hurry, don’t give a crap about what I say to them and only want their SHIT NOW are in the majority. I do thank God for the 20% or so of the people who really listen to me & allow me to actually make a difference in their lives. HOWEVER, the larger number of customers are staring holes in me, complaining under their breathe, or out loud about how slow this pharmacy is, this,that & the other. Every day I do my best to take care of each PATIENT, not cause anyone any harm, and to not let the stress of everyone pushing me to do more, faster, next, drive me insane. And excuse me, but 15 minutes in the corner of the pharmacy is not a break! Sounds like you may be more of a slave to the powers that be than myself. I step outside for a 5 min.break to smoke at least 3-4 times daily and if I have properly set myself up & can be gone for 30 min. I eat lunch & smoke in my car. And besides, I’m no slacker, ummmm, not saying that you are. But someone who drags their ass through the day, taking as much time with each PATIENT as they require is not going to accomplish as much as someone who is fast, efficient, knows how to close a conversation, multi-tasks and delegates. You’re just leaving more work for the other pharmacists in your store. A true professional carries their own weight. I don’t know who you work for, but I can tell you, I don’t own the company, I don’t get to call the shots. Fact is, I work for someone else and IF I want to keep my job, I have to do as they say AND accomplish the company goals, without harming anyone. And I can do all this, EVEN with the gun to my head. Next time I do plan to came back as the one in charge, the owner or the CEO. Difference between you & me peond__k, is you don’t see the gun to your head. Pay attention sweetheart.

Hey, Peon…what color is the sky on your planet??? Or you are living/working in some parallel universe?? There is a “corner” in your pharmacy to sit undisturbed? And you are allowed to store and eat food in your department??? No one sends you emails that you will be counseled about your wt/pt, pci calls, or the number of “red” in the queue??? Oh, yeah, we have no “gun” to our heads….I forgot. Mojome is correct….folks can be “written up”, transferred to a store 30 miles away, have their hours cut, or be told they are not a team player and be offered a “severance” package.

Every single pharmacist who has to work in these conditions has the right to “whine”. You must be a DM who has not worked in a real pharmacy in 20 years.

I had the patients call when all of this went down. They were told by CVS that if the pharmacy called they would clear the problem up. I called one time which entailed a two fucking hour phone call and was told to call back later “when the computer came back on line”.

Yeah right. It costs more to run the script for HN/CVS patients than their so called “reimbursement”. Fuck you CVS and lick my ass while you’re at it.

Joni, I am a pharmacist working for a major chain. There is a balance between what we can safely do and what corporations expect of us. That balance is set by us. We cannot control the expectations of the companies for which we work. But, we can control how we work and how well we safely take care of patients. If we allow the pressures of the job to cause us to cut-corners with patient safety, then we expose ourselves, the patients, and the company to harm. As I see it, patient safety is the issue which divides us from plumbers, electricians, carpenters and etc. We are healthcare workers. There is no doubt about it. Why? Because we have a patients safety in our hands. We need to recognize that our “health” is important to taking care of patients. How well will you perform your job if you have been on your feet for 8 hours with no break and nothing to eat? At this point you are putting the patients safety at risk, your job on the line, and the company potentially facing a lawsuit.

bcmigal, I am a pharmacist and I work for a major chain. I have been in pharmacy for 40 years. For 25 years, I worked for independents. I know what pharmacy was like in the past and how it is today. Pharmacists are due at least 50% of the blame for the state of chain pharmacy today. If you run around like a crazy chicken, then you can expect to be treated like a crazy chicken. Stop whining about the job. If they fire you, see if there is grounds for a lawsuit, and sue them. If no grounds, move on to another job, and maybe you will find a better one. If you don’t, then get out of pharmacy, go back to school, and get another kind of job. Or, instead of whining, UNITE! Ok..you will start complaining about no where to join. Well, join The Pharmacy Alliance…only organization that is after the best interests of the working pharmacist. For 20 years, I have been hearing pharmacists complain, and I have done my share of complaing. But, at some point, you have to decide what you are going to do. Are you going to keep working like an idiot, or are you going to work like a professional? Are you going to whine or are you going to join an organization and work for change. I have selected the latter route. I joined The Pharmacy Alliance, and through them I am working for change. I may go down as a peon pharmacist, but I will go down fighting.

Just to stir up the cvs fans here….what do you all think and TAP think of the emilys law in ohio…our chain pretends to care about new hires going thru a bogus training process suppose to train the newbies to do data entry ins claims pa’s and etc etc by end of 3 months LOLOLOL!! yeah right! most cant find drugs on shelf that quickly! And least we forget the employees who under emilys law who have been hired for more than 5 yrs will have to pass a new \certification\ either NPTA or state test by oct 2010…our chain has done NOTHING to inform this techs of these changes and prepare them for testing some will not pass..yeah thats how they will cut more hours & yes hiring is frozen–sure you can get more help if you do more than 2500 a week gee thanks!! I am a cpht but we can only do so much and shouldnt the other techs have to go thru NPTA testing not made up \sure they’ll pass\ retail chain dictated testing standards?? any thoughts on emily law??

Thought I would reply to peon, who seems to have all the answers. The days when there were five jobs for every pharmacists are over. It is easy to say”let them fire you”. How far will one get suing a powerful company with 7000 stores? At the latest meeting, folks were told that if they cannot conform, then they will be replaced. So much for feeling like a valued employee. You are right, I could get out of pharmacy, but I would be dead before I finished another degree. What has your Pharmacy Alliance done so far? Forced the chains to follow labor laws? Regulated the amount of techs a pharmacist needs to fill Rxs? Limited the number of hours or consecutive days that a pharmacist works ? Let me know and I will get on board

I currently work at the pbm (CVS/Caremark). Yea other people have to deal with that healthnet issue. They were saying it was healthnets fault. I had to decided to a go to pharmacy school myself due to the fact that I have a masters degree and I answer phones all with calls from Pharmacies. But I will say this though. I have spoke with some of the most IGNORANT pharmacist and pharm techs. They scream at ME because they cannot get the medication to go through. Problem is I am NOT the help desk. And I am also NOT the plan. If the medication is not covered take the alternative I give you and get the hell off my phone.

Fe we are only screaming at you because we are frustrated. The pharmacist can not change the prescription. By the time we get your ass on the phone we have already needlessly wasted time and money trying to care for the patient. Your intervention should be with the physician not with the pharmacist. Did the pharmacist order the medication? Stop wasting valuable resources just so you can have a job. I say shut the fuck up with your master’s degree and get a job that doesn’t slow down the delivery of health care to patients maybe do something that is actually productive. Are you sick? Does it make you feel good to perpetuate your nonsense? Don’t worry, I have medicine for that, it can really help you, oh wait, it’s not on your formulary, I guess you’re fucked now. Get off you your high horse

Everyone seems to be forgetting the fact that most of the issues on this blog (and all the other pharmacist blogs) stem from the fact that the working conditions are absolutely unacceptable. 12, 14 hours with no break day after day IS NOT NORMAL FOR AN EDUCATED HUMAN BEING! I am a strong believer in the idea that a normal work day would make us happy with this job. We should use websites like this to form a voice instead of talking about fucking insurance glitches. Caring about whether or not the DAW box is filled out correctly might not be such a fucking stressful issue to a full grown man after a 15 minute nap in your Audi and a slice of pizza. Why is this so hard for everyone to realize???????

It is not normal for any human being. We are less than indentured servants. Oh , I forgot, we are not supposed to whine about it or some self righteous person will get all bent out of shape and use language you would hear at a truck stop.

Btw, Fe, I have been in this business longer than you’ve been alive, and I have never heard a pharmacist or tech speak harshly to anyone at a third party help desk. We think you should get combat pay.

NY Rx, you are so right. I do not know of any (emphasis on any) health care provider who works under our conditions. And it is only getting worse with our employers tracking every move. Is a surgeon rated on how many operations he/she can perform in a shift? ( That valve replacement took too long!) Perhaps we will be fitted with OnStar.

We are a threat to the safety of ourselves and others…..sadly, it does not seem to matter.

I received another rejection today from CVS/Caremark because refills for maintenance meds are not covered at my pharmacy. The rejection message gave a phone number for the patient to contact CVS/Caremark. So we called them together. The patient was instructed by CVS/Caremark to go to their nearest CVS pharmacy and get a 90 day supply of their Rx or use the mail order service. The patient was also informed that no quantity of drug will be allowed to be filled at any other pharmacy. The patient later called me up and told me that CVS was filling her Rx for her for a 90 day supply. She told me that she just handed the bottle to the pharmacist and she got 90 days worth of her medicine. I never got a call for a copy. Do you think the CVS pharmacist called the doctor and got a new Rx for 90 days or do you think that they just rewrote it for 90 days? Does it matter? Who’s going to audit them anyway?

Does anyone see a problem here? They eliminate the competition and police themselves. When did CVS/Caremark get a license to print money? The patient is supposed to be able to choose the pharmacy not the other way around. This has got to be great for the drug companies as well because now they can make deals with CVS to only dispense their ppi or one statin for everyone. CVS’s inventory will be much cheaper to acquire and manage. A brilliant idea if your name is SATAN. If this continues, I see only 2 chains left standing at the end, Walgreens and CVS. Are these the types of companies that you want to practice pharmacy for? They are making money faster than you can say “Sherman Anti-Trust Act”

I work for CVS in Illinois, and we are STILL having issues with duel-billing. And of course, since we have the stupid Caremark name attached, we get all the angry people asking why “our” insurance is doing this to them. They don’t seem to understand that we have nothing to do with Caremark, and that I would happily sever ties with them. We even get customers from different pharmacies calling us to yell about their insurance. I hate Caremark…

I am an RPh for CVS and let me tell you, we are as annoyed by Caremark just as much as all the rest of you. We get all the same cryptic reject messages as you do, and we dial the same help desk # as everyone else too (can dial 800-421-2342 in my sleep). Being owned by the same parent entity as the Caremark PBM confuses a lot of customers, and apparently it confuses some people in the profession, too. Walgreens/WHI started the whole retail/PBM merge thing a few years ago, and we lost a good deal of retail business to Walgreens because they forced people to WAGs for maintenance meds.
I’m not going to defend forcing people to pick either CVS or mail order for maintenance meds, but keep in mind people have been getting pushed to mail order for years now. At least this gives them an option. I’m sorry for you that the option is with us, but i have as much power over their insurance contracts as anyone else on here. And it seems like for every nice customer we pick up with the switch we get 5 or 6 shitty ones. Any everyone is pissed off, or at least confused, by it. As far as I am concerned, you can keep them.

I love it how patients come to the counter are are surprised about their copays. I had one bitch come up to my counter to get 3 different drugs. I ring her up and she looks at me with a weird looks and explains. OMG I have never paid this much money for these medications. I hear this all the time so I go look in the computer. This bitch has been getting these same meds for over 3 years and has always paid the same amount for them. So I tell her you have paid this same exact amount for this medication for the last 3 years. “oh”, she says. Then she goes onto the next drug…”well I know I have never paid this much for this one”…same thing I go look into the computer again and everything repeats itself. Dumb bitch was not on any alzheimers meds. I have a fucking line here I don’t have time to hear you bitch about how much your drug costs and especially don’t try to act shocked when you have paid the same amount for the last several years and have the balls to tell me you didn’t. Damn that shit pissed me off and then I had a whole fucking line after dealing with her

AAAARRRGGGGHHHH!!! SO glad to see this website! I’m a PATIENT! I work for the BIGGEST COUNTY in AMERICA – County of San Bernardino in California. I’ve been paying extra for years for the only PPO offered – HealthNet. Those bastards have been using Caremark for their prescription management for years… this fiscal year, starting July 1, 2010, guess what? They are FORCING all PPO subscribers to use CVS/Caremark for alll maintenance meds. WHAT?!?!?!?! I LOVE my community pharmacy! I know he’s been getting gradually screwed for years. I have, too – I’m a doctor. But hell, to FORCE us to use f***ing CVS for all maintenance meds?!?! What the hell???

So what does that mean to my beloved independent pharmacy? The one non-maintenance prescription I get every two or three years goes to him? The hydrocodone from the dentist or the antibiotic when I really screw myself up in the garden and give myself some lovely infection? The ONE TIME A YEAR I need a cough suppressant? This is infuriating! I’m calling congressmen and the FTC and TWO NEWSPAPERS I’m going to fight this damn thing! Of course, I called HealthNet to lodge a complaint. They care. They really care.

Stay angry! This doesn’t have to continue! Thanks for the website. I’m bookmarking this one.

typos abound, i assume the readers have brains that can process. If its “annoying” or difficult to figure it out u need the practice:)

Man I’m serious,you must be miserable..

I know you think “its a law, obey it” means laws are not subject to error, but
step out of your angry black and white world and take a phreilin forte, or a lomotil, or any other non scheduled controlled drug or C-V(hey, a barb with apap sucks, but with asa? oh, what a rush. lol) or hell, just dig out any remaing paregoric and feel mother natures blessing.

You wont become a crackhead screwup, no way, youd then hate them and the world,equally without much thought, 100% reactionary.

Whos better off, a person who has a drug dependence, and whose life sucks, and whose loved ones suffer with them but aren’t held in ill regard:**

or angry ol you. larry craig, whom i would bet a pinky finger and a half sliced thumb is amongst the top 10 most hate filled people in the world, he is happier than you are. Though he was a doing what he despised, and you..

weak. weak weak weak…
are u human with an iq above most, which u seem? than you can do what you will, but you wont.

you could and should be homeless and proud.

“but, i have duties, i…”

If you are married, tell your wife you cant support her, divorce her and give it all to her, (which is about a tenth of what she’s due for the pain your anger as caused) and u have to go live another life

sorry if u are a woman, I, like we all do, make use of stereotyped thinking to free up resources.. stereotyoping rocks, just not when people either pretend they dont, or dont see its usage when and for what it is.

why hate those who have to slither up to the counter and fumble their script to you, asking for whatever brand in particular (“I don’t know, just as long as its watson man. None of that meloncrockt stuff. (i know real sp, dont worry)) and knowing you think they are shit..

am i one?

not in the way you think.

you are as addicted to your anger and by now your justifications as suzie who wrote an extra zero after 120 for her oc’s.

oxy-c….. not a “timeless” one, not compared to oxy-m.

I was relieved when their 4o mg dilaudid xr was pulled cuz beeer affected the polymer (theres an rd dept. Lets see, our target audience:american couch potatos in pain from their transfornmation into a potato. what shall we consdier a likely issue? not beer, thats for sure, so lets nix beer testing..)
but horrified when i heard about opana.

numorphan, consigned to the “preferred over smack” category of narcs, abd forgotten, this veritiable quintesse of opiate bliss(as well as Tx averse tolerance)suddenly is brought back to life?

oh surely it was by some small nobody corp, like cephalon was for modafinil.

surely it isn;t as biggie. and of course it isn’t P Pharma, no one would be that dumb. Thats saying “yeah yeah, lets be real, we are the afghanistan of the tablet world.

No lunch breaks, corporate quotas, superhuman expectations, whipping boy/girl for the public, who sometimes smells worse than their attitude…sounds like floor help at Sears/K Mart/Home Depot/ or any other major retail chain.

The corporatocracy has influenced big Pharma and its deendrils I expected health care to at least give its worker ants a bathroom and lunch/dinner break. Catching those potentially fatal interractions deserves a litle upkeep-food and waste elimination might be a good place to start.

You see, those years spent as a student of pharmacy, all those suffixes, prefix and odd nomenclature you thought were part of knowing what you are doing ARE NOTHING COMPARED TO BEING A BUSINESS ADMINISTRATOR OR A CORPORATE EXEC. They stop to check the quality of their chain’s branches when the corporate jet runs out of Martinin mix(you’d better make sure you didn’t go too heavy on the Nyquil, the zen masters may call at any time). You may be talking to a pharmaceutical “secret shopper” so watch it with your foolish commitment to patients or you may fail the more important, random litmus test.

I cant stand these old farts…I have about 5 of them at my cvs and they just want to talk….It’s like cant you see im working….Go watch a soap and leave me the hell alone…Even more hilarious, is when they try to return stuff they got somewhere else…About a week ago this lady comes in trying to ask me return this heorrhoid treatment medicine called hemrid. I thought maybe it was something new we carried so ofcourse i look up her account and its not on there and i’m like, come on lady you didnt buy this here..Then she admits she bought it online and asks me if it interacts with her current meds..It turns out its an herbal medicine she bought online…ofcourse im too darn nice and i look it up and there’s a whole ton of stuff on it curing hemorrhoids…anyone else heard of this stuff or are selling it??? I just told her to ask he r pcp ofcourse…but im curious. I found some stuff about it on http://herbalhealthreviews.com

I absolutley agree, there is no way that I’m going to call the patients’t insurance provider. If the patient does not have the needed info so that we can bill their insurance they can pay cash or come back later after THEY give us all the billing info. The Pharmacy is not your babysitter!